Hello and welcome to another AMBOSS tutorial. In this video, we'll show you how to scrub
in using the counted brush stroke method. There's also an alternative scrubbing technique
- the alcohol-based hand rub. We cover this method in a separate tutorial, which you can access here.
Let's go!
Before you get started, remove all jewelry and accessories from your hands and wrists.
Then, grab a scrub brush packet,
open it, and place it on the ledge beside the faucet, open-side up.
A prewash is only necessary before the first scrub of the day and if your hands
are visibly dirty. For this, wash your hands and forearms once thoroughly with regular soap.
If necessary, you should also clean your nails using the nail pick.
Then, wash the soap off completely. Once your hands and nails look clean,
you can start with the actual scrub! First, lather up the brush with water.
The surgical brush is usually impregnated with an antiseptic. If not, add the antiseptic now. Then
turn off the faucet to avoid wasting water. If the faucet isn't sensor-activated, use your elbow.
The brush has two sides: a soft spongy side and a rough abrasive side.
The rough side should only be used to clean your fingertips and nails.
Throughout the procedure, keep your hands away from your clothing and higher than your elbows
so that the water drains away from your hands. Start with the fingertips and nails of the
first hand, scrubbing them with about 30 strokes using the rough side of the brush.
Next, move on to the fingers of the first hand, for which you'll use the soft sponge side.
Work your way systematically from the little finger to the thumb.
The key principle of the brush stroke method is scrubbing all four anatomical sides. Use at least
10 brush strokes on each side. When scrubbing your little finger and thumb, you should include the
whole medial and lateral edges of the hand. Then clean the palm and back of your hand,
scrubbing them thoroughly with 10 brush strokes each.
Now you can move on to the forearm.
Mentally divide it into two halves, which you will clean in turn.
For each half, scrub all 4 sides, using 10 brush strokes on each side. Do one area at a time;
once you've finished one part, you shouldn't go back to it!
And again, remember to keep your hands higher than your elbows.
Now, repeat everything on the other side. Let's summarize the steps as a reminder:
Scrub your fingertips and nails using about 30 brush strokes with the rough side of the brush.
Then switch to the spongy side of the brush and work your way from your little finger
to your thumb, covering all 4 sides of each finger. Use 10 brush strokes for each side,
and include the medial and lateral edges of the hand.
Next, scrub the palm and back of the hand with 10 strokes each.
Finally, move to the forearm, which you should clean in two halves: first, wrist to mid-forearm,
then mid-forearm up to the elbow. For each half, use 10 brush strokes on each of the 4 sides.
Now it's just a matter of washing off the antiseptic foam.
Keep your arms bent with your hands higher than your elbows so that the water runs away from
your hands. Move your hands, followed by your forearms, slowly through the stream of water.
If you can still see some foam, don't move your arm back and forth through
the water, simply repeat this step. Unfortunately, if you accidentally touch
something that is non-sterile, you will have to start again, so be mindful of your surroundings.
Now all that's left is to dry your hands and forearms: You may be handed a sterile
towel by a surgical assistant or there may be a sterile paper towel provided with the gown.
For each side, start by drying your hand, including the spaces between the fingers,
and move up towards your elbow. Make sure you don’t let the towel or your
arms touch your scrubs and don't go back over areas that you've already dried!
And that's it! Your hands are scrubbed clean and you are ready to gown and
glove. Make sure you keep them at chest height and a safe distance from your body
and surroundings to avoid touching anything. Check out our other tutorials for step-by-step
instructions on gowning and gloving here! Also check out the AMBOSS article for more
tips on working in the OR. See you next time!